Amanda Nichole Smith, ATC/OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31005393A Issued in IN

Practice address

11143 Parkview Plaza Dr Ste 100
Fort Wayne, IN 46845-1728

Phone

(260) 266-7400

Fax

(260) 266-7439

NPI assigned

Dec 29, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Florida Surgeons, PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1912953290
  Medicare reassignment Care Compare group NPD
• North Florida Surgeons, PA

  dba NFS Florida Bone and Joint

  • Orthopaedic Surgery Physician
  • Gulf Breeze, FL
  • NPI 1871442053
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1144550963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11143 PARKVIEW PLAZA DR STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451728",
            "telephone_number": "260-266-7400",
            "fax_number": "260-266-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "credential": "ATC/OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001238A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005393A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda R Smith-Wilson, N.P.
• Shiloh Marie Smith-Wittwer, LMHCA, LPC
• Adrienne Smith, LMHC
• Alyssa R Smith, BCBA
• Amanda Marie Smith
• Amber Smith, RD
• Amber Smith
• Amy Sue Smith, LPN
• Andrea Smith
• Andrea Jantson Smith, MSPT

• Occupational Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.